A Karim1, V Cubas2, S Zaman3, S Khan3, H Patel2, P Waterland3. 1. Department of Colorectal Surgery, Worcester Royal Hospital, Charles Hastings Way, Worcester, WR5 1DD, UK. ahmedkarim101@yahoo.com. 2. Department of Colorectal Surgery, Worcester Royal Hospital, Charles Hastings Way, Worcester, WR5 1DD, UK. 3. Department of Colorectal Surgery, Russels Hall Hospital, Dudley, UK.
Abstract
BACKGROUND: The aim of the present study was to perform a systematic review and meta-analysis of cancer-specific outcomes after curative rectal cancer surgery comparing anastomotic leak (AL) with no leak. METHODS: PubMed, Medline and Embase databases were searched to identify studies comparing cancer-specific outcomes after rectal cancer surgery in patients with AL and without. A meta-analysis with a random-effects model was used to calculate pooled odds ratios (OR) and confidence intervals (CI) for each outcome measure. RESULTS: A total of 18 studies were included for meta-analysis, comprising a total of 18,039 patients after curative rectal resection (1764 AL, 16,275 without AL). The overall rate of AL was 9.8%. After AL and excluding 30-day mortality there was an increased risk of local recurrence (OR 1.50; CI 1.23, 1.82), worse overall survival (OR 0.69; CI 0.60-0.81), decreased disease free survival (OR 0.51; CI 0.36-0.73) and cancer specific survival (OR 0.71; CI 0.54-0.94). Distant recurrence (OR 1.10; CI 0.89-1.37) and overall recurrence (OR 1.33; CI 0.64-2.76) were not significantly different between the two groups. CONCLUSIONS: AL may negatively impact cancer-specific outcomes after curative rectal cancer surgery and could be considered an independent negative prognostic factor.
BACKGROUND: The aim of the present study was to perform a systematic review and meta-analysis of cancer-specific outcomes after curative rectal cancer surgery comparing anastomotic leak (AL) with no leak. METHODS: PubMed, Medline and Embase databases were searched to identify studies comparing cancer-specific outcomes after rectal cancer surgery in patients with AL and without. A meta-analysis with a random-effects model was used to calculate pooled odds ratios (OR) and confidence intervals (CI) for each outcome measure. RESULTS: A total of 18 studies were included for meta-analysis, comprising a total of 18,039 patients after curative rectal resection (1764 AL, 16,275 without AL). The overall rate of AL was 9.8%. After AL and excluding 30-day mortality there was an increased risk of local recurrence (OR 1.50; CI 1.23, 1.82), worse overall survival (OR 0.69; CI 0.60-0.81), decreased disease free survival (OR 0.51; CI 0.36-0.73) and cancer specific survival (OR 0.71; CI 0.54-0.94). Distant recurrence (OR 1.10; CI 0.89-1.37) and overall recurrence (OR 1.33; CI 0.64-2.76) were not significantly different between the two groups. CONCLUSIONS: AL may negatively impact cancer-specific outcomes after curative rectal cancer surgery and could be considered an independent negative prognostic factor.
Authors: Fateme Rajabiyazdi; Marylise Boutros; Natasha G Caminsky; Jeongyoon Moon; Nancy Morin; Karim Alavi; Rebecca C Auer; Liliana G Bordeianou; Sami A Chadi; Sébastien Drolet; Amandeep Ghuman; Alexander Sender Liberman; Tony MacLean; Ian M Paquette; Jason Park; Sunil Patel; Scott R Steele; Patricia Sylla; Steven D Wexner; Carol-Ann Vasilevsky Journal: Surg Endosc Date: 2022-10-04 Impact factor: 3.453
Authors: Katarina Dibdiakova; Adam Svec; Zuzana Majercikova; Marek Adamik; Marian Grendar; Juraj Vana; Alexander Ferko; Jozef Hatok Journal: Mol Clin Oncol Date: 2021-12-21